A Song of Resilience

August, 2015

Photo Credit: Ronny Krashinsky

For some providers, emotional resilience lies at the intersection of medicine and music. I had the pleasure of listening to a series of piano recitals in San Francisco’s Botanical Gardens earlier this summer. After one pianist finished playing a beautiful duet with a cellist, she stood up and introduced herself as Dr. Rupa Marya, a physician at UCSF and a professional musician.   Intrigued by this mixture, I asked her some questions.

Dr. Marya has been playing the piano since age 8. In college, she studied a unique combination of theater arts and molecular biology before completing her medical training. According to Dr. Marya, the commonalities of each field of study lay in their celebration of life and life’s processes, regardless of whether these occurred on a molecular or a broader, social level.

“Every art is an exercise in observation and in open-mindedness,” Dr. Marya said. “With the art of diagnosis, physicians hold on to a working model but look at what other things we can change. The comfort with fluidity that one cultivates in other art forms is appropriate to medicine. For example, when a case is not cut-and-dry but requires more emotional and cognitive training, art teaches comfort with uncertainty and accompanying people through it.”

The piece played by Dr. Marya that I especially enjoyed was called, “Winters.” It was her own composition and one inspired by a young man with cancer who passed away in the ICU with his new wife by his side. Dr. Marya had been touched by her patient’s strength and humor throughout his care, and was humbled by her own role as one of the last people who he would encounter during the course of his life. She was committed to managing his physical pain while offering him solace and companionship during his final hours in order to make them as precious as possible. After his passing, she used the piano as a meditation on the experience.

Dr. Marya made me recall and reflect upon a conference hosted by the Center for Compassion and Altruism Research And Education (CCARE) that I attended last year. One speaker was noted physician and author Dr. Abraham Verghese who spoke about the importance of rituals. “Rituals are about transformation…they signify crossing of a threshold…and this transformation is the embodiment of compassion.” For Dr. Marya, her music is a meditative experience and ritual that allows her to handle the complex emotions resulting from practicing medicine. “Music is a place where I can really put those feelings and wrestle with them,” she said.

Dr. Marya’s advice to future doctors is to develop a practice of digesting what they witness that reminds them of the gift they have and the privilege of acting as a physician. “We get so caught up in the rigmarole of the hospital – dealing with insurance companies and all of these other things. Create a ritual with colleagues or other people who are empathetic or sympathetic [to the situation]. Have a way of expelling it from your body, either through story or song so you can continue to take care of people. It can be enlivening to do so.”

Dr. Marya, thank you for setting an example for the field.